The present invention generally relates to the management of pain associated with applying electrical cardioversion therapies. In particular, the invention relates to patient-controlled pain suppression via patient administered sedation.
Implanted medical devices are capable of detecting and treating an arrhythmia (i.e., irregular heartbeats) in a patient. In one example, the implanted medical device includes a defibrillator that applies an electrical pulse therapy to a patient""s heart upon detecting fibrillation (i.e., high, irregular heartbeat), a form of arrhythmia. Cardioverters or defibrillators discharge relatively high energy electrical shocks or pulses into or across cardiac tissue to arrest a life-threatening atrial or ventricular fibrillation upon detection by the implanted medical device. Defibrillation shocks, while highly effective at arresting the fibrillation, may occur suddenly and can cause considerable patient discomfort.
Currently, defibrillation shock induced discomfort is managed with concomitant intravenous sedation. Intravenous sedation therapies require close medical supervision because the sedative agents cause a loss of consciousness and a lower respiration rate. Hence, sedative agents are not used by ambulatory patients to provide relief from defibrillation induced discomfort without medical supervision.
Ambulatory patients can administer oral sedatives (e.g., narcotics) at home to reduce patient discomfort. However, oral sedatives can incapacitate the patient for long periods of time and reaction time to the sedative is uncertain because the absorption rate varies between patients. With an oral sedative it is also difficult for the patient to synchronize the time of the shock delivery with the maximum sedative effect. In some cases, the patient may fall asleep even before activating the defibrillator. Traditional oral medications can also be misused/abused irrespective of detecting the arrhythmia. Intranasal narcotics are available but they only slightly reduce patient discomfort associated with the defibrillation shock.
Accordingly, there is a need for a system for enabling a patient to effectively control the pain associated with an electrical therapy via patient administered sedation. An approach that addresses the aforementioned problems, as well as other related problems, is therefore desirable.
Various embodiments of the present invention are directed to addressing various needs in connection with patient-controlled pain suppression of an electrical therapy using a non-implanted drug delivery device.
One embodiment of the invention is directed to a system for patient management of pain associated with an electrical therapy. The pain management system includes an implanted medical device that detects an arrhythmia of a heart and telemetrically communicates from the implanted medical device an arrhythmia condition. The system also includes an external drug delivery arrangement that receives telemetric communications on the arrhythmia condition from the implanted device and provides an alert of the arrhythmia condition to the patient. The external drug delivery arrangement communicates to the implanted device information that a drug has been administered to the patient. The implanted medical device includes a capacitive circuit that delivers the electrical therapy to the heart in response to the drug being administered.
In a related embodiment, the implanted device includes a stimulator circuit that delivers an electrical therapy to a selected portion of the patient""s body. Upon detecting an irregularity (an irregularly operating body function) at the selected portion, an external drug delivery arrangement receives telemetric communications from the implanted device of the irregularity and provides an alert of the irregularity to the patient. The external drug delivery arrangement communicates to the implanted device that a drug is being administered to the patient. The stimulator circuit delivers the electrical therapy to the selected body portion in response to the drug being reacted to by the patient.
Another embodiment of the invention is directed to a system and a method for patient management of pain associated with an electrical defibrillation therapy. The pain management system includes an implanted cardiac defibrillator (ICD) device having a circuit that detects fibrillation of a heart and a circuit that telemetrically communicates from the ICD device a fibrillation condition of the heart. The system includes an external drug delivery arrangement that receives telemetric communications on the fibrillation condition of the heart and provides an alert of the fibrillation condition to the patient. The external drug delivery arrangement communicates to the ICD that the drug is being administered and that the drug is being reacted to by the patient. The system also includes a drug interaction verification circuit that provides an alert to the external drug delivery arrangement in response to the reaction to the drug. The implanted device includes a capacitive circuit that delivers the electrical therapy in response to the reaction to the drug.
The above summary of the present invention is not intended to describe each illustrated embodiment or every implementation of the present invention. The figures in the detailed description that follow more particularly exemplify these embodiments.